SPORTS MEDICINE

SPORTS MEDICINE; Sports Turnaround: The Team Doctors Now Pay the Team

By BILL PENNINGTON

Published: May 18, 2004

Once, professional sports teams paid the best physicians they could find to treat their players, but that practice could soon be as old-fashioned as the house call.

These days, groups of doctors or hospitals are paying the teams.

In an upside-down scenario spawned by an increasingly competitive health-care market, hospitals and medical practices -- eager for any promotional advantage -- have begun bidding to pay pro teams as much as $1.5 million annually for the right to treat their high-salaried players. In addition to the revenue, sports franchises get the services of the provider's physicians either without charge or at severely discounted rates.

In return, the medical groups and the hospitals are granted the exclusive right to market themselves as the team's official hospital, H.M.O. or orthopedic group. In a nation of aging baby boomers and weekend warriors with aching, tattered joints and ligaments, being designated the place where sports stars are nursed back to playing shape has precious value.

''People believe if a team doctor or an official hospital is good enough for their favorite athletes, then it must be good enough for their favorite athletes, then it must be good enough for them,'' said Dr. William O. Roberts, president of the American College of Sports Medicine. ''But the purchasing power of these groups doesn't necessarily reflect their abilities.''

Despite concerns among many doctors and the players' unions over the ethics of putting health care out to bid, about half the teams in the four major North American professional sports are now tied contractually to a medical institution. Industry analysts expect that number to grow significantly.

The business model comes in various forms.

The Mets, for example, are paid more than $1 million a year by the New York University-Hospital for Joint Diseases, with the hospital providing the services of its doctors at no cost. In return, the hospital advertises at Shea Stadium and receives free tickets and periodic visits from players at hospital events. When the Mets signed their seven-year deal in 2001, their longtime team doctor, Dr. David Altchek, was let go.

The Yankees previously had a contract with Continuum Health Partners, but they currently do not have an arrangement with anyone.

In Houston, Methodist Hospital pays the Astros and the Texans a combined $2 million a year. Team doctors come from Methodist Hospital. The teams pay the doctors, although at a discount rate. The hospital receives free stadium signage, tickets, and radio and TV advertising, in addition to the right to put the team logos and the official hospital designation on its Web site.

In Boston, doctors from New England Baptist Hospital had treated Boston Celtics players for a dozen years without any formal business relationship until 1999, when the hospital decided to establish one. The team and the hospital agreed on a 12-year contract; New England Baptist built a $32.5 million training center, which the Celtics have been using, and in exchange the hospital receives advertising, tickets and the cachet of having its physicians recognized as the team doctors. The key element in every case is the team's endorsement of the health-care provider. Sports industry experts say that teams for years have had official soft drinks, official beers and official pickup trucks, so why not official health-care providers?

''I guess it is a sign of the times,'' Claude T. Moorman III, director of sports medicine at the Duke University Medical Center and a former N.F.L. team doctor, said with resignation. ''For goodness' sake, even the cheerleaders have a sponsorship deal.''

Many doctors, however, are deeply concerned about the propriety of these arrangements. ''These groups should have to put out a disclaimer: 'We paid for the ability to treat these top athletes,''' said Dr. Robert Huizenga, a former team doctor for the Oakland Raiders and past president of the National Football League Team Physicians Society. ''What's it say about our profession when the most high-profile jobs are awarded not by merit, but by auction?''

''It doesn't sound quite right, and there is a clear conflict of interest,'' Dr. Brock said. ''It doesn't strike me as unprecedented, since health providers do often negotiate discounts to purchasers who provide a large number of patients. But given the celebrity of these teams, it taps into, in a prominent and worrisome way, the broader concerns about the inner penetration between corporate interests and medicine.''

Dr. Gordon Matheson, editor in chief of The Physician and Sports Medicine, a journal, and Stanford University's team doctor, said: ''It hurts us all. Do physicians fight over the right to take care of a run-down section of town? These arrangements can't help but imply some competition for secondary financial gain, and that doesn't jibe with the central values of health care.''

Dr. Andrew Bishop, the Atlanta Falcons' team doctor for 11 years, said he would resign if the team wanted to enter into a sponsorship deal with a hospital group.